The overall goal of this project is to improve the rheumatology education of residents in training, particularly those in programs where there is limited education input from a rheumatologist. The project will seek to demonstrate that a patient instructor can effectively teach residents the history taking, physical examination and interpersonal skills that are basic to clinical rheumatology. The patient instructor approach will be tested locally and then disseminated to other training programs. The patient instructor project will involve five specific steps: 1) develop a formal protocol of assessment items and education feedback responses that can be used in clinical teaching sessions for house officers to teach them basic rheumatology skills; 2) train a patient who has rheumatoid arthritis to employ educations protocol during simulated patient-physician encounters; 3) conduct a controlled trial at our Center to demonstrate the impact of the patient instructor technique on the rheumatology skills of medical residents; 4) train patients from other institutions to serve as educators at their local programs; and 5) evaluate the performance of these patient educators at the participating training programs. The main significance of this project is that it should demonstrate an effective and relatively inexpensive way to improve the rheumatology education of residents in training. The project will also build on our previous education studies with patient assessors as well as work that others have done on the use of standardized patients as educators.